Managing the Well Child
As a basic requirement, the Well Child Framework includes seven core contacts for each child before their fifth birthday. These visits capture a child's developmental milestones: undertaking nursing assessments, recording weight, height and health outcomes. Nurses handwrite clinical notes and record data into the child's 50-page Plunket Health Record (PHR). Client appointments are scheduled manually and are mostly recorded in paper diaries.
To maintain their clients' privacy, Plunket nurses collect the paper files they need before they start their visits each day, returning them to their base office at the end of the day to be stored securely.
The trouble with paper
Although Plunket's model of care has evolved over the years, they still retained a paper based system. This meant that with over 55,000 new babies added to the service every year, Plunket were responsible for storing hundreds of thousands of paper files for a set regulatory period.
While Plunket has a legacy contact system, it holds just that — contact details. The more specific details of a child's progress remain in the painstakingly maintained Plunket Health Records. Should an authorised health professional require information on a child, the relevant pages of that file are faxed, scanned and emailed, or if the family or child relocates, the entire PHR file is transferred to the nearest Plunket branch via courier or post.
As a health provider Plunket is required by the Ministry of Health to perform regular audits on their current client health records — the manual auditing of files is a time consuming task.
Andrea McLeod, Chief Operating Officer for Plunket, was very conscious of the risks inherent in their paper based system. "We didn't have an easy way of monitoring the consistency and quality of the data entered in the client files from one nurse to the next. From a health statistics point of view accuracy of health data is paramount."
By moving to electronic records we became more efficient, holding real-time data that we could share with not only our staff and funders, but other necessary health providers. It also put us in a better position to respond rapidly to health trends, or a public health situation, something that was previously problematic because of our paper-based recordsAndrea McLeod, Chief Operating Officer for Plunket
Time to move forward
In terms of technology, Plunket had a strong vision of where their service needed to go, and a good grasp of how to get there. In 2014 they decided the time was right to make the move.
The organisation needed an electronic system that fully supported the Well Child Service Framework and transformed the way its frontline staff recorded and accessed client health information. The system needed to fully replace the traditional paper records and diaries.
It had to be integrated and interactive, highly efficient, give Plunket access to digital information, and provide nurses with the ability to work online or offline seamlessly. To increase the value of the data, critical metrics, as well as out-of-the-ordinary information needed to be tracked, analysed and reported on by child, district and demographic. Reporting and auditing processes needed to be both streamlined and compliant, and real-time reporting made available to both internal and external stakeholders.